Asphyxia of newborns is a complication developing in the early postpartum period. This pathology is accompanied by a violation of the breathing process and the work of the cardiovascular system in the baby. Consider this state in more detail, determine its causes, types, we will find out: what distinguishes hypoxia of the fetus and asphyxia of the newborn.
What is "asphyxia" in a newborn baby?
Asphyxia of newborns is a condition of a small organism in which there is a violation of breathing. In this case, there is a difference between this pathology and the definition of "hypoxia of the newborn." Oxygen starvation ( hypoxia ) develops during pregnancy or childbirth (placental exfoliation, pressing the umbilical cord), and is accompanied by insufficient intake of oxygen. The breathing process is not violated. Asphyxia (suffocation) is characterized by a temporary cessation of breathing and requires resuscitation.
Causes of Asphyxiation of Newborns
Asphyxia in a child during childbirth can be provoked by numerous factors. In this case, the causes that cause pathology, can be directly related to the process of delivery and with the characteristics of intrauterine development of the fetus. Among the main pathological factors that cause asphyxia, doctors distinguish:
- Sharp, sudden malfunctions in the bloodstream and in the umbilical cord - a knot of the baby's neck , the formation of a node on the umbilical cord, a constriction.
- Disruption of the gas exchange process in the utero-placental system - improper presentation of the child's place, premature and partial detachment .
- Failure in the process of circulation in the placenta, caused by high blood pressure in the mother.
- Reduction of the oxygen level in the blood of the mother in childbirth - anemia , cardiovascular diseases, respiratory system diseases.
- The difficulty of breathing in the fetus is anomalies of lung development, chronic infectious processes, the consequence of medications taken.
These causes provoke primary asphyxia of newborns, which develops in the process of delivery. However, asphyxia can also be secondary in character when a disorder occurs immediately after the baby's birth. Among the reasons for secondary asphyxiation is:
- aspiration of the respiratory tract - fluid entering the lungs;
- violation of the circulatory process of the brain;
- immaturity of the lungs - the body is not able to perform respiratory movements;
- congenital malformations of the brain, heart, lungs.
Degrees of asphyxia of newborns
Depending on the clinical picture and severity of the disorder, physicians distinguish several degrees of pathology. Evaluation is carried out immediately after the birth of the baby in the first minute. Classification of asphyxia of newborns is as follows:
- light degree;
- average;
- heavy;
- clinical death.
Asphyxia of neonatal mild
Asphyxia of mild degree is characterized by absence of screaming, however the baby's reaction to touch is present. The breathing of the newborn is independent, but slow and irregular. The legs and hands have a cyanotic shade, the heart activity is not broken. After cleaning the upper respiratory tract from mucus and fluid, carrying out tactile stimulation (stroking the back, patting on the heels) and oxygen therapy through the mask, the condition of the newly born is normalized.
A child born in a state of moderate asphyxia, subsequently has no problems with breathing. In this case, small neurological disorders are possible, in the form of:
- increase of muscle tone;
- tremor of handles, legs, lower jaw.
Asphyxia of moderate severity in the newborn
This degree of impairment is also characterized by the absence of screaming at the time of birth. In this case, the reaction to tactile stimuli of touch is not observed. A characteristic feature of this form is a change in the color of the skin, so it is often referred to as blue asphyxia of newborns. Respiratory movements are of a single nature, however, heart activity is not impaired.
The average asphyxia of the newborn requires ventilation. To do this, more often use a special bag, occasionally an oxygen mask. The transferred form of pathology always leaves a mark on the health of the infant, provoking neurologic changes:
- increased excitability - causeless cries, prolonged tremor of handles and legs;
- depression - sluggish breast sucking, low motor activity (movements with arms and legs are practically not carried out).
Asphyxia of severe degree in newborns
A severe degree of pathology is accompanied by a complete lack of breathing at the time of birth. The skin due to lack of blood circulation becomes pale. Because of this, this form of pathology is referred to as white asphyxia of the newborn. When carrying out a tactile test, the baby does not react to touch. There is a violation of the cardiovascular system - when listening to heart sounds are strongly muffled or completely absent. A strong bradycardia develops.
This asphyxia of newborns requires urgent resuscitation. The actions of the doctors are aimed at restoring the respiratory and cardiac activity of the newborn. The child is connected to the respirator. At the same time, the umbilical cord is administered with medications that stimulate cardiac activity. Such kids for a long time are on the hardware breathing, and subsequently develop severe neurological disorders, it is possible to delay neuropsychic development.
Clinical death of a newborn
The clinical death of an infant occurs when doctors fix the complete absence of signs of life. In this case, after birth, the baby does not perform any self-inhalation, there is no cardiac activity, the reaction to stimuli too. Correct and timely initiation of resuscitation measures gives hope for a favorable outcome. In this case, the severity of neurological consequences for the health of the baby depends on how long was the lack of breathing. In such situations, the brain is severely damaged.
Asphyxia of the newborn - symptoms
To assess the severity of this pathology, doctors use the Apgar scale. The method is based on the evaluation of several indicators at once:
- reflex excitability;
- breath;
- heart activity;
- muscle tone;
- color of the skin.
For each parameter, points are added, which are summed and an overall score is output. The results look like this:
- easy degree - 6-7 points;
- average - 4-5;
- heavy - the kid is gaining 1-3 points;
- clinical death - 0 points.
When exhibiting a degree of asphyxia, midwives assess the present symptoms of the disorder. The pulse in asphyxia in newborns is reduced and is less than 100 beats per minute. For an easy degree of asphyxia are characteristic:
- the first breath takes place at 1 minute;
- muscle tone decreased slightly;
- nasolabial triangle of blue color;
- breathing is weakened.
With an average degree of asphyxia, doctors fix:
- weakened breathing
- The legs and arms turn blue;
- the number of heartbeats decreases;
- muscle tone decreased;
- pulsation of the umbilical cord is observed.
The severe degree of this pathology is manifested by the following symptoms:
- breathing is absent;
- severe bradycardia;
- muscle atony;
- pallor of the skin;
- development of adrenal insufficiency;
- strong pulsation of the veins of the umbilical cord.
Asphyxia of newborns - consequences
Talking about how dangerous asphyxia in newborns, doctors note that with a serious degree of violation, the death of an infant is possible. It happens in the first hours of life. With an average and mild degree, the prognosis is favorable. The outcome depends on the time of resuscitation, the presence of concomitant disorders. The consequences of the pathology that developed during the newborn period can arise, both in the first hours of life, and at an older age.
Asphyxia in a newborn after childbirth - consequences
Severe asphyxia of newborns, the consequences of which depend on the correctness and timeliness of the therapy begun, does not pass without a trace for the body. Complications can occur, both at the early stages of perinatal development, and at an older age. Complete brain atrophy after asphyxia in infants occurs rarely. Among the frequent complications of the early recovery period:
- convulsive encephalopathy;
- hydrocephalus;
- hypertensive syndrome;
- hypo- or hyperexcitability.
Asphyxia of newborns - consequences in older age
Asphyxia and hypoxia of newborns are related to those complications of pregnancy that affect the baby's health after his birth. Problems can appear in a few months, and sometimes even years. Among the late complications:
- meningitis;
- pneumonia;
- sepsis.
Treatment of asphyxia in newborns
When assessing the Apgar scale 4 points or less, conducted in the first minute, resuscitation is required. Resuscitation of a newborn in asphyxia is carried out in 4 stages:
- Release of the respiratory tract, ensuring their patency. It is carried out with the help of a catheter and an electric pump. If asphyxia occurs in utero, the manipulation of the cleaning is carried out immediately after the appearance of the head.
- Maintaining the breathing process. Auxiliary ventilation is carried out with the help of a breathing bag, and if ineffective, intubation is performed and an artificial ventilation device is connected.
- Restoration of the circulatory system. For this purpose, a closed body massage is performed, even with cuts (with a bradycardia of 60-70 beats per minute). It is carried out by pressing on the sternum with two thumbs, with a frequency of 100-120 times a minute. When cardiac activity is not restored within a minute, proceed to the next stage.
- Administration of medicines. At this stage of therapy, doctors use the following drugs to treat neonatal asphyxia:
- Atropine 0.1% - 0.05-0.1 ml;
- Adrenaline 0.1% - 0.02-0.03 ml;
- Sodium bicarbonate - 1-2 ml.
Prevention of asphyxia of newborns
In order to prevent a formidable complication - fetal and newborn asphyxia, preventive measures should be taken both at the stage of pregnancy planning, and when the baby is born. Among the main directions:
- Timely therapy of extragenital diseases in pregnant women.
- Management of the process of gestation taking into account risk factors.
- Conduction of intrauterine monitoring of fetal and placenta conditions (dopplerography, ultrasound).
- Prevention of hypoxia during labor, timely clearance of the respiratory tract.